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- Title
Slipped capital femoral epiphysis management and the arthroscope.
- Authors
Accadbled, F.; May, O.; Thévenin-Lemoine, C.; de Gauzy, J. Sales
- Abstract
Background In situ pinning of slipped capital femoral epiphysis (SCFE) results in various degrees of deformity of the femoral head-neck junction. Repetitive trauma from cam-type femoroacetabular impingement (FAI) can lead to labral tears and injury to the articular cartilage causing loss of function. Arthroscopic osteoplasty is an alternative to open procedure and to Southwick/Imhäuser-type osteotomies in symptomatic selected cases. Surgical technique The amount of bone to be resected has to be carefully planned pre-operatively. Only gentle traction is applied on a well-padded perineal support. A spherical burr is used to gradually resect the prominence. Intra-operative fluoroscopy is very useful when checking adequate reshaping of the head-neck junction is obtained. Results Arthroscopy often reveals acetabular cartilage lesions, labrum hyperhemia and fraying which rarely require repair. Arthroscopic osteoplasty provides satisfactory pain relief and, to a lesser extent, restores hip internal rotation. Conclusion Arthroscopic osteoplasty is more technically and time-demanding in post SCFE than idiopathic FAI. It requires strong arthroscopic skills and experience in hip arthroscopy. It stands as a reasonable alternative to open procedure or flexion osteotomies in symptomatic FAI post mild to moderate SCFE. It provides pain relief and to a lesser extent restores internal rotation of the hip.
- Subjects
FEMORAL epiphysis; ARTHROSCOPES; HUMAN abnormalities; FEMUR neck; FEMORACETABULAR impingement; BONE grafting; DISEASES
- Publication
Journal of Children's Orthopaedics (British Editorial Society of Bone & Joint Surgery), 2017, Vol 11, Issue 2, p128
- ISSN
1863-2521
- Publication type
Article
- DOI
10.1302/1863-2548-11-160281